Work 1:1 with members prior to member registration and during ongoing treatment to address questions on eligibility, benefits, payment, and more
Educate members about benefits, member responsibility, payment options and financial assistance
Complete ongoing eligibility checks, prior authorizations, and solve complex insurance issues on behalf of our members, working directly with the payer where needed
Communicate with our members over video and insurance companies on the phone where necessary
Review and process prior authorization and other forms
Requirements
Bachelor’s degree preferred
At least two years of experience with direct member-facing experience in patient access, financial counseling, and/or utilization management; SUD/Behavioral Health setting strongly preferred
Experience speaking with SUD/Behavioral Health patients to interpret their coverage, benefits, patient responsibility, and more
Experience working with members via telehealth
Experience with state Medicaid portals, (Availity and Zendesk preferred)
Experience speaking directly with payers and navigating payer organizations to solve problems
Experience and working knowledge of commercial, Medicare, and Medicaid plans with behavioral health/SUD coverage and benefits
Experience creating and explaining payment plans to SUD/Behavioral Health members
Skill in responding quickly to member needs
Skill in quickly learning about new insurance plans
Skill in operating effectively in a remote environment
Skill in operating electronic medical records (eClinicalWorks experience preferred)
Skill in operating other needed technology
including video-conferencing, ticketing systems, and more
Experience in a high-growth environment strongly preferred